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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/advagg_css\/css__ce2QY63WIanKyr8eSq7eavr1XQRRmFD6ZSmwpyJi8lM__zXwFqpqmxrZOXXcd_TpBQpjuELbmIP9wBR5UuTDWAO4__YJWWMMdfCJuAFm5cUEp88OsodhO3ZA-2lzRfoBsSlk4.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003ELong-term cardiovascular morbidity and mortality rates are just as high for patients with non-ST-segment elevation myocardial infarction and unstable angina as for patients with STEMI, according to a long-term analysis of data from the Global Registry of Acute Coronary Events (GRACE).\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003EMyocardial Infarction\u003C\/li\u003E\u003C\/ul\u003E\u003Cp id=\u0022p-2\u0022\u003ELong-term cardiovascular (CV) morbidity and mortality rates are just as high for patients with non-ST-segment elevation myocardial infarction (NSTEMI) and unstable angina (UA) as for patients with STEMI, according to a long-term analysis of data from the Global Registry of Acute Coronary Events (GRACE).\u003C\/p\u003E\u003Cp id=\u0022p-3\u0022\u003EThe late consequences of NSTEMI and UA are poorly recognized and often underestimated, according to Keith Fox, MD, University of Edinburgh, Scotland, who presented long-term findings from the GRACE study (published simultaneously online in the \u003Cem\u003EEuropean Heart Journal\u003C\/em\u003E).\u003C\/p\u003E\u003Cp id=\u0022p-4\u0022\u003EIn the long-term GRACE analysis, Prof. Fox and colleagues sought to evaluate the late clinical outcomes following STEMI, NSTEMI, and UA and to determine whether the GRACE risk score predicts long-term risk of all-cause mortality, CV death, and MI among patients with acute coronary syndrome (ACS). In total, 3721 patients from GRACE registry centers in the UK and Belgium were included in the long-term study.\u003C\/p\u003E\u003Cp id=\u0022p-5\u0022\u003EAfter 5 years, a similar proportion of patients in each ACS category had died, including 19% of STEMI patients, 22% of NSTEMI patients, and 17% of UA patients. The majority of these deaths occurred after initial hospital discharge, regardless of index event. In STEMI patients, 66% of all deaths up to 5 years occurred after hospital discharge. By comparison, 86% of NSTEMI deaths and 97% of UA deaths up to 5 years occurred after hospital discharge in the GRACE cohort. Although rates of in-hospital mortality and MI were higher following STEMI, the cumulative rates of death were not different over the duration of follow-up in the STEMI (22%) and NSTEMI\/UA groups (26%; p=0.21).\u003C\/p\u003E\u003Cp id=\u0022p-6\u0022\u003EDespite high rates of CV medication use during the index hospitalization and 6 months following discharge, long-term CV morbidity was also high. Across all ACS groups, many patients experienced one or more late complications, including MI (12.7%), stroke (7.7%), revascularization (16.7%), or hospital readmission for suspected ACS (53.6%).\u003C\/p\u003E\u003Cp id=\u0022p-7\u0022\u003EThe GRACE risk score accurately predicted long-term outcomes in patients with STEMI, NSTEMI, and UA. Relative to low-risk patients, the risk of death was 2-fold higher in the intermediate-risk group (HR, 2.14; p\u0026lt;0.0001) and 6-fold higher in the high-risk group (HR, 6.36; p\u0026lt;0.0001). When examined according to index ACS event, baseline GRACE risk scores were highly predictive of in-hospital mortality, 5-year mortality, and the combined endpoint of CV death and MI in both the STEMI and NSTEMI\/UA groups (p\u0026lt;0.0001 for all comparisons).\u003C\/p\u003E\u003Cp id=\u0022p-8\u0022\u003EBy accurately predicting long-term outcomes, the GRACE risk score can be used to identify which ACS patients are most likely to benefit from aggressive secondary prevention, Prof. Fox concluded.\u003C\/p\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2010 MD Conference Express\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/10\/8\/33.1.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzmpk5\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}